Provider Demographics
NPI:1437752102
Name:DR. JEFFREY A SALADIN, DENTAL CORPORATION
Entity Type:Organization
Organization Name:DR. JEFFREY A SALADIN, DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-877-7450
Mailing Address - Street 1:1164 NATIONAL DRIVE
Mailing Address - Street 2:SUITE 40
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834
Mailing Address - Country:US
Mailing Address - Phone:916-877-7450
Mailing Address - Fax:844-534-8464
Practice Address - Street 1:2350 WHITE LANE
Practice Address - Street 2:SUITE C
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304
Practice Address - Country:US
Practice Address - Phone:661-401-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty